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Diagnostic Cardiology

Our Services > Heart Care > Diagnostic Cardiology

A full range of diagnostic testing can be performed at Wadley including:

These are noninvasive procedures that do not invade the body’s surface. They are safe, painless and normally performed on an outpatient basis. Examples of these type of procedures done at Wadley include: electrocardiogram and echocardiogram. The electrocardiogram or EKG is used to detect and record the electrical activity generated by the heart. Most people are familiar with the EKG because the test is often given as part of a general physical exam.

Echocardiography is another type of noninvasive test. This test relies on high frequency sound waves that are bounced off tissue in the heart and are reflected back through a transducer (a small microphone-like device) held on the patient's chest. A computer uses the information coming from the transducer to construct an image of the heart, which is displayed on a television screen and can be recorded on videotape or printed on paper.

The various diagnostic techniques complement each other and provide more information about the patient's heart to his physician.


Stress Tests
Another vital diagnostic tool in the care of the heart is a stress test or exercise test combined with an EKG. The stress test is used to see how the heart performs when it is asked to work harder. While the patient is walking and is connected to EKG equipment, the heart rate and rhythm can be monitored. Another type of stress test is a medication- induced stress test. If a patient is unable to walk, a medication (e.g. persantine) may be given to produce an effect on the heart as though the patient were exercising. To make a stress test more useful, it may be combined with infusion of a nuclear material (called a nuclear stress test) in which a radioactive isotope is injected through a vein. It moves through the bloodstream and settles in the heart muscle. A special camera is then used to picture the heart and blood flow in the heart muscle to determine if there are blockages. The stress test may also be combined with echocardiography (stress echo). Your doctor will know exactly which type of stress test is best for you.


Ambulatory electrocardiography (also, Holter Monitoring)
Holter Monitoring is another noninvasive diagnostic procedure, where a patient wears a small recording device as he or she goes through their normal life. The device records the heart’s electrical currents, allowing it to document any abnormalities. The patient normally wears the Holter monitor 24-48 hours.


Nuclear Cardiology
This diagnostic process involves the use of radioactive dyes which are injected into an individual's blood stream, where they flow to the heart. Advanced technology including x-rays, CT scans, and MRI are then used to examine the heart for abnormalities.


Cardiac Catheterization
The non-invasive tests often point the way to a need for additional procedures, such as cardiac catheterization. The cardiac cath has been described as the most important cardiac diagnostic method developed in recent years. Wadley offers two fully equipped digital catheterization labs. A cardiac cath involves inserting a flexible narrow plastic tube (catheter) into a vein or artery in a patient's upper leg (groin) or arm. The catheter is then passed through the blood vessel into a heart chamber or to a coronary artery. Special x-ray dye, called contrast, is injected and allows the doctor to visualize the coronary arteries and evaluate the heart chambers and valves. X-rays are made and other tests are done such as taking blood samples and measuring the pressure inside the heart. The quality of the equipment in a cath lab is important. State-of-the-art equipment provides more information and a quicker turnaround time in making a diagnosis and treatment plan. Wadley is the only hospital in Texarkana that utilizes an Intravascular Ultrasound (IVUS) in our Cath Lab. The IVUS allows the physician to see arteries from the inside out through a tiny camera and through high frequency sound waves that give a cross-sectional view or picture of the artery, displaying distinct arterial layers in shades of gray or color. This state-of-the-art equipment enables our physicians to get detailed and accurate measurements of blockage and vessel size, plaque area and volume as well as verifying proper stent placement.


Rhythm Disorders
Patients can have difficulty with the heart's rhythm and electrical signaling. There are many different forms of arrhythmias, or irregular heart beats. Some include tachycardia (heart beats too fast), bradycardia (heart beats too slow), atrial fibrillation, supraventricular tachycardia, Wolfe Parkinson White syndrome, neurogenic (syncope), ventricular tachycardia, and other complex arrhythmias. Heart rhythm disorders can be treated with medications, and our specialists work with the most current medical regimens available. Arrhythmias may also require the use of devices, such as pacemakers, often done through catheters, for the greatest control of the problem.


Pacemakers and Defibrillators
There are a variety of heart rhythm disorders including tachycardia (heart beats too fast), bradycardia (heart beats too slow), and irregular heart rhythms. These abnormal rhythms usually cause palpitations or a feeling of skipped beats, and range from benign to life threatening. Many abnormal rhythms are treated with medications, but some respond best to pacemaker insertion. We offer highly specialized approaches to heart rhythm problems including:

• Full range of the newest pacemakers to treat slow heart rhythms and help prevent recurrence of the tachycardia.

• Implantable cardioverter-defibrillators (ICDs) which are on standby to convert or shock life-threatening rhythms and also function as pacemakers.

• Biventricular pacemakers which can help to improve left ventricular function in selected patients with congestive heart failure and also treat the bradycardia.

Need a Cardiologist?



Dr. Scott Black is a board certified interventional cardiologist and the founder of Advanced Cardiology of Texarkana, now Cardiology Specialists.  He graduated from the University of Arkansas for Medical Sciences in 1997.  He then completed a fellowship in interventional cardiology in 2000 at the Texas Heart Institute in Houston, Texas.  Dr. Black specializes in complex coronary interventions, including balloon angioplasty, stents, cardiac rhythm management, and intravascular ultrasound.  Dr. Black is also a fellow of the American College of Cardiology.  Dr. Black is a life long resident of Texarkana.  He and his wife, Melinda, have two children, Molly and Brooks.


Dr. Kevin Formes received his degree in medicine from the University of North Texas Health Science Center in Fort Worth in 2003.  His residency in Internal Medicine and Fellowship in Cardiology and Interventional Cardiology was completed at Plaza Medical Center in Fort Worth in 2010.  Dr. Formes was awarded Fellow of the Year for 2008-2009 and also served as Chief Cardiology Fellow.  He is Board Certified and is a member of the American College of Cardiology, American Osteopathic Association, Texas Osteopathic Medical Association, and the American Medical Association.  Dr. Formes specializes in invasive and interventional cardiology and peripheral vascular disease.  He and his wife, Laura Harland Formes, have three children:  Bladen, Kelin, and Morgan.


Dr. Poongodhai Ramachandran received her degree in medicine from the University of Madras in India in 1990.  Dr. Ramachandran is a board certified Invasive Cardiologist who specializes in the care of patients diagnosed with cardiovascular disease and promotes wellness through community education. She completed her residency at Mercy Hospital in Pittsburgh, Pennsylvania and her fellowship in Cardiovascular Diseases at the University of Pittsburgh Medical Center in Pittsburgh, Pennsylvania.  She is married to Sunil and they have two children, Anjali and Shalini.


Shannon Humphrey, ACNP graduated from Texarkana College School of Nursing with honors in 1998.  She later received her Bachelor of Science in Nursing from Texas A&M – Texarkana in 2003 and her Master of Nursing Science from the University of Arkansas for Medical Sciences in 2006 through the acute care nurse practitioner program.  She has specialized in cardiovascular disease management for over six years.  Shannon is nationally certified as an acute nurse practitioner by the American Nurses Credentialing Center and is also a member of the Sigma Theta Tau International Honor Society of Nursing.  She and her husband Clint have two sons, Jacob and Jared.